U.S. patent number 6,556,698 [Application Number 09/294,503] was granted by the patent office on 2003-04-29 for method and system for associating exposed radiographic films with proper patient information.
This patent grant is currently assigned to Eastman Kodak Company. Invention is credited to Francesco Diano, Giovanni Venturi.
United States Patent |
6,556,698 |
Diano , et al. |
April 29, 2003 |
Method and system for associating exposed radiographic films with
proper patient information
Abstract
A method and system is described which facilitates the proper
association of radiographic film with a patient information. The
invention maintains information for each patient to be examined in
the current day and generates a unique identifying ID code for each
patient to be examined. Before examining a patient, the current
patient's unique identifier is imaged on an unexposed radiographic
film. After the patient is examined and the film is exposed, the
film is developed and digitized. Patient information is retrieved
and associated with the digitized medical images by analyzing the
digital image data in order to determine the patient's unique
identifier. In this manner, the invention ensures the proper
association of patient information with exposed radiographic film.
Once properly associated, the digital image data and the patient
information can be communicated to a Picture Archiving and
Communication System. The present invention also allows for
interfacing with a hospital's Radiology Information System, thus
eliminating the need for manual entry of patient information.
Inventors: |
Diano; Francesco (Vado Ligure,
IT), Venturi; Giovanni (Genoa, IT) |
Assignee: |
Eastman Kodak Company
(Rochester, NY)
|
Family
ID: |
8231818 |
Appl.
No.: |
09/294,503 |
Filed: |
April 20, 1999 |
Foreign Application Priority Data
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Apr 24, 1998 [EP] |
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98107487 |
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Current U.S.
Class: |
382/132;
250/370.09; 250/390.02; 707/E17.022 |
Current CPC
Class: |
G03B
42/047 (20130101); G06F 16/5846 (20190101); G16H
30/20 (20180101); H04N 1/32101 (20130101); H04N
2201/3226 (20130101) |
Current International
Class: |
G03B
42/04 (20060101); G06F 17/30 (20060101); H04N
1/21 (20060101); G06K 009/00 () |
Field of
Search: |
;382/128,129,131,132,130,282,284,298 ;358/457
;378/28,46,90,92,140,165,166 ;250/370.09,390.02 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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0414042 |
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Aug 1990 |
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EP |
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0 452 570 |
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Oct 1991 |
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EP |
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Primary Examiner: Johnson; Timothy M.
Assistant Examiner: Tabatabai; Abolfazl
Attorney, Agent or Firm: Noval; William F.
Claims
We claim:
1. A system for associating a radiographic film with patient
information comprising: an imager for imaging a label having a
unique patient identifier on a radiographic film; an input imaging
device including: a processor for developing the radiographic film
having the label imaged thereon, thereby forming at least one
visible medical image on the radiographic film, and a film
digitizer coupled to the processor for digitizing the medical image
and the label image, thereby producing digital image data; and an
interface device for analyzing the digital image data to determine
the patient identifier of the label and associating the digitized
radiographic film with one of a plurality of patients based on the
determined patient identifier; wherein the interface device stores
patient information in an information table having a plurality of
entries such that each entry of the information table has a unique
identifier, wherein the interface device selects one of the entries
of information table when the unique identifier of the selected
entry corresponds to the unique patient identifier of the
label.
2. The system of claim 1, wherein the interface device analyzes the
digital image data by performing optical character recognition
techniques on the digital image data to determine the patient
identifier of the label.
3. The system of claim 1, wherein the interface device further
comprises: a patient identification station managing the
information table including retrieving patient information from the
selected entry; and a network interface for receiving the digital
image data from the input imaging device and communicating the
patient identifier to the patient identification station, wherein
the patient identification station communicates patient information
from the selected entry to the network interface.
4. The system of claim 3, wherein the network interface
communicates the digital image data and the patient information
received from the patient identification system to a Picture
Archiving and Communicating System.
5. The system of claim 4, wherein the patient identification
station communicates the patient information to the network
interface in compliance with the DICOM standard.
6. The system of in the network interface includes a DICOM manager
for building a DICOM file containing the digital image data and the
patient information received from the patient identification
system, wherein the network interface communicates the DICOM file
to the Picture Archiving and Communicating System.
7. The system of claim 3, wherein the patient identification
station updates the information table by retrieving current patient
information from a radiology information system.
8. The system of claim 3, wherein the patient identification
station includes a visual interface for providing a visual display
to allow an operator to modify the patient information of the
information table.
9. The system of claim 8, wherein the network interface includes a
failure manager for generating an error message when the network
interface is unable to determine the patient identifier of the
label from the digital image data, and further wherein the failure
manager communicates the error message to the visual interface to
allow the operator to enter patient information for the developed
radiographic film.
10. The system of claim 3, wherein the patient identification
station includes a print server for retrieving at least one unique
identifier of the entries of the information table and
communicating the retrieved unique identifier to the label imager
for imaging as the patient identifier on the radiographic film.
11. The system of claim 3, wherein the patient identification
station is a software module executing on a first computer and the
network interface is a software module executing on a second
computer.
12. The method of claim 11, wherein the selecting step includes the
steps of: retrieving patient information from the selected entry;
and communicating the digital image data and the retrieved patient
information to a Picture Archiving and Communicating System.
13. The method of claim 12, wherein the communicating step
communicates the digital image data and the retrieved patient
information in compliance with the DICOM standard.
14. The method of claim 13, wherein the communicating step building
a DICOM file contains the digital image data and the patient
information received from the patient identification system.
15. The method of claim 11, wherein the storing step includes the
step of retrieving current patient information from a radiology
information system.
16. The method of claim 11, wherein the storing step includes the
step of providing a visual display to allow an operator to modify
the patient information of the information table.
17. The method of claim 16, wherein the providing step includes the
step of displaying an error message when the analyzing step is
unable to determine the patient identifier of the label from the
digital image data to allow the operator to enter patient
information for the developed radiographic film.
18. The method of claim 17, wherein the printing step includes the
step of retrieving a bar-code representing the patient identifier
on a patient card.
19. The method of claim 11, wherein the imaging step includes the
step of retrieving at least one unique identifier of the entries of
the information table and communicating the retrieved unique
identifier to a imager for imaging as the patient identifier of the
label.
20. The system of claim 1, wherein the system further comprises a
bar-code printer to form a bar-code on a patient card in order to
represent the patient identifier.
21. A method for associating a radiographic film with one of a
plurality of patients comprising the steps of: imaging a label
having a patient identifier on a radiographic film; developing the
radiographic film having the label imaged thereon to form at least
one visible medical image on the radiographic film; digitizing the
medical image and the label image to produce digital image data;
analyzing the digital image data to determine the patient
identifier of the label imaged on the radiographic film; and
associating the developed radiographic film with one of the
patients as a function of the determined patient identifier;
wherein the associating step comprises the steps of: storing
patient information in an information table having a plurality of
entries such that each entry of the information table has a unique
identifier; and selecting one of the entries of information table
when the unique identifier of the selected entry corresponds to the
patient identifier of the label.
22. The method of claim 21, wherein the analyzing step performs
optical character recognition techniques on the digital image data
to determine the patient identifier of the label.
Description
FIELD OF THE INVENTION
This invention relates generally to the field of medical imaging,
and more particularly to a method and system for associating
exposed radiographic films with proper patient information.
BACKGROUND
Many modern hospitals have implemented a variety of digital medical
modalities such as a magnetic resonance (MR), computed tomography
(CT), digital radiography, and ultrasound devices. These
modalities, often referred to as input imaging devices, produce
vast numbers of diagnostic quality digital images. In order to
handle the large volume of digital images, many hospitals have
implemented networks of specialized equipment and components
specifically designed to facilitate medical radiological imaging.
Such a network is commonly referred to as a Picture Archiving and
Communicating System (PACS). A PACS allows a radiologist to easily
manage digital medical images including storing, retrieving, and
viewing the images. For example, when a patient is imaged by a
medical modality, a series of digital images, often referred to as
a "study", is generated and archived at a central database.
Typically each study contains general patient information such as
name, date of birth, an assigned physician and the type of medical
modality that produced the images. This information is often
entered by hospital personnel from a workstation while the patient
is being imaged. After imaging is complete, a radiologist can
easily retrieve the patient's study from the database and print the
images on a medical imager.
A medical imager processes the pixel data of the retrieved medical
images and generates output image data. For example, in a
continuous tone laser imager, the output image data represents
exposure levels necessary for a scanning assembly to accurately
reproduce the original image on an imaging element. The output
image data is used to modulate the intensity of the scanning laser
while exposing the imaging media, thereby forming the visible
representation of the original image. Other medical imagers use
different imaging techniques to form output images such as direct
thermal imaging, ablation imaging, dye transfer, ink jet, dye
sublimation and thermal mass transfer.
In addition to easily printing stored medical images, a PACS allows
a radiologist to view each image on a diagnostic-quality display
station. This eliminates any expense and effort involved in
printing the images. Furthermore, after viewing the images, the
radiologists can forward the study to another radiologist, perhaps
located at a remote hospital, for further review. In this fashion,
PACS have greatly improved patient care and the efficiency of
radiology departments.
One area that has not benefited from the recent progress in
managing and archiving images is conventional radiography (X-ray).
In conventional radiography, a radiographic film captures an
image-wise exposure of a patient. The exposed film is then
chemically developed to form a visible image. Because of the high
image quality, conventional radiography is still the predominant
diagnostic technique employed by radiologists. Unfortunately,
because of the exposure and development process, conventional
radiography has been unable to enjoy the benefits associated with
digital imaging described above. Many hospitals have attempted to
address this problem by turning to film digitizers which digitize
radiographic images formed on radiographic films. Once the
radiographic image is available in digitized form, such an image
can be archived, retrieved and manipulated in any of the various
ways offered by a PACS. For this purpose, the developed film is
manually removed from the developer and fed into the film
digitizer. This approach, although producing a digital image,
requires vast amounts of time and labor. Furthermore, manual
operations are required in order to associate each digitized image
to the proper patient and the communication of the complete study
to the PACS. Such a manual operation requires a high degree of
attention and is prone to error. For example, patient information
is often associated with the wrong image. Another attempt to solve
the above problem, as discussed in U.S. Pat. Nos. 5,237,358,
5,583,663 and EP 452,570, has been to directly couple the film
processor to the film digitizer such that developed film is fed
directly into the film digitizer. This technique requires less time
and manual labor and offers other benefits including reducing the
chance the film is blemished with finger marks, dust, or the like.
This technique, however, does not address the problem that the
generated images must be associated with the proper patient
information.
By facilitating the management of digital medical images, PACS have
greatly improved patient care and the efficiency of radiology
departments. For the reasons stated above, and for other reasons
stated below which will become apparent to those skilled in the art
upon reading and understanding the present specification, there is
a need in the art for a method and system which facilitate the use
of conventional radiographic film in a PACS environment. There is
also a need for a method and system which automatically associates
medical images from exposed radiographic film to correct patient
information.
SUMMARY OF THE INVENTION
The present invention is directed to a method and system for
automatically associating a radiographic film with one of a
plurality of patients. In one embodiment, the present invention
generates a unique code for each patient that is scheduled for
examination. When a particular patient is to be examined, the
patient's corresponding unique code is imaged on an unexposed
radiographic film. The patient's image is captured on the
radiographic film which is then developed to form at least one
visible medical image on the radiographic film. The developed
radiographic film is digitized to produce digital image data.
According to the present invention, the digital image data is
analyzed to determine the unique code of the examined patient that
was imaged on the film. The proper patient information is
associated with the developed radiographic film based on the unique
code as determined from the digital data. According to one aspect
of the present invention, the digital image data is analyzed
according to optical character recognition techniques.
According to yet another aspect, the present invention stores
patient information in an information table having a plurality of
entries such that each entry of the information table can be
accessed by one the unique identifiers. After a radiographic film
is digitized, the information table is accessed according to the
unique identifier determined from the digital image data in order
to retrieve proper patient information. In one embodiment, the
present invention retrieves current patient information from a
radiology information system.
According to one feature, the present invention retrieves the
proper patient information and communicates the digital image data
and the retrieved patient information to a Picture Archiving and
Communicating System. In one embodiment, the digital image data and
the retrieved patient information is communicated in compliance
with the DICOM standard, such as by constructing a DICOM file.
According to yet another aspect, the present invention provides a
visual display to allow an operator to modify the patient
information of the information table. For example, an error message
is displayed when the present invention is unable to determine the
unique patient identifier from the digital image data. Providing a
visual display allows the operator to enter patient information for
the developed radiographic film.
In another embodiment, the present invention is a system for
associating a radiographic film with one of a plurality of
patients. The system includes an imager for imaging a label having
a unique patient identifier on radiographic film. The system
further includes an input imaging device having a processor for
developing the radiographic film with the label imaged thereon,
thereby forming at least one visible medical image on the
radiographic film. A film digitizer is coupled to the processor for
digitizing the medical image and the label image, thereby producing
digital image data. An interface device receives the digital image
data and analyzes the digital image data in order to correctly
associate the developed radiographic film with one of the patients.
According to one aspect of this embodiment, the interface device
stores patient information in an information table having a
plurality of entries such that each entry of the information table
has a unique identifier. The interface device selects one of the
entries of information table when the entry's unique identifier
corresponds to the unique patient identifier of the label as
determined from the digital image data.
According to one aspect of this embodiment, the interface device
further comprises (i) a patient identification station for managing
the information table including retrieving patient information from
the selected entry, and (ii) a network interface for receiving the
digital image data from the input imaging device and communicating
the patient identifier to the patient identification station.
According to another aspect of this embodiment, the network
interface includes a DICOM manager for building a DICOM file
containing the digital image data and the patient information
received from the patient identification system, wherein the
network interface communicates the DICOM file to a Picture
Archiving and Communicating System. These and other features and
advantages of the invention will become apparent from the following
description of the preferred embodiments of the invention.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a block diagram of one embodiment of a medical image
management system having an interface device for associating
radiographic film to proper patient information in accordance with
the present invention;
FIG. 2 is a block diagram of one embodiment of the interface device
having a network interface and a patient ID station;
FIG. 3 is a block diagram of one embodiment of the network
interface;
FIG. 4 is a flowchart illustrating one mode operation of network
interface;
FIG. 5 is a block diagram of one embodiment of the patient ID
station;
FIG. 6 is a flowchart for illustrating one mode of operation of a
visual interface for the patient ID station;
FIG. 7 is a flowchart for illustrating various operations that may
be performed by hospital personnel via the visual interface;
and
FIG. 8 is a flowchart for illustrating one mode of operation of a
data server of the patient ID station.
FIG. 9 is a flowchart for illustrating one mode of operation of a
printer server of the patient ID station.
FIG. 10 is a flowchart for illustrating one mode of operation of a
RIS interface of the patient ID station.
DETAILED DESCRIPTION
FIG. 1 illustrates one embodiment of a medical image management
system 10 in block diagram form. System 10 includes input imaging
device 15, medical imager 20, interface device 30, label imager 40,
Radiology Information System (RIS) 50, PACS 60, and bar-code
printer 70. Input imaging device 15 produces digital images and
communicates the images to interface device 30. For example, in one
embodiment input imaging device 15 includes a processor for
developing conventional radiographic film, such as film exposed via
conventional X-ray, and a digitizer coupled to the processor for
receiving the developed film and generating digital image data by
digitizing the radiographic film. In one preferred embodiment,
input imaging device 15 comprises the apparatus described in EP
Application No. 97-120678.4 filed on Nov. 26, 1997 and titled
"Apparatus for Processing And Digitizing A Radiographic Film," the
description of which is herein incorporated for reference.
As will be described in detail below, interface device 30 maintains
information of patients scheduled to be examined and control label
imager 40 such that a unique patient identifier is imaged on each
radiographic film used for examining the scheduled patients. After
input imaging device 15 develops and digitizes a radiographic film,
interface 30 receives the generated medical images in the form of
digital image data and automatically associates each of the images
with the correct patient information by examining the digital image
data and determining the unique patient identifier. After
associating the proper patient information with each image,
interface device 30 communicates the digital image data and the
proper patient information to PACS 60. In one embodiment, interface
device 30 communicates the medical images and the associated
patient information to PACS 60 using a data communications protocol
developed by the American College of Radiology (ACR) and the
National Electrical Manufacturers Association (NEMA) known as the
DICOM protocol. The DICOM protocol is typically implemented using a
TCP/IP connection between the communicating devices. By
automatically associating images generated by input imaging device
15 with proper patient information, interface device 30 eliminates
the vast amounts of time and labor required to enter patient
information and ensure the association of the information with the
appropriate images.
In addition to communicating received images to PACS 60, interface
device 30 may communicate the images to medical imager 20 which is
any medical imager suitable for forming a representative output
image on an imaging element. Typically, input imaging device 15
communicates the input pixel data of the input image as well as
imaging commands that specify operations to be performed by medical
imager 20 on the communicated input pixel data such as image
rotation or polarity reversal. In one embodiment, medical imager 20
is a continuous tone laser imager. Furthermore, the imaging element
may be photographic such that medical imager 20 includes a
processor station (not shown) for chemical processing and
developing of the output image formed on the imaging element. In
another embodiment, the imaging element is photothermographic which
can be thermally processed and need not be chemically
processed.
FIG. 2 illustrates one embodiment of interface device 30 having a
network interface 100 and a patient ID station (PIDS) 110. In
addition to receiving the digital images from input imaging device
15, network interface 100 is responsible for all communications
with PACS 60 including, in one embodiment, the construction of
appropriate DICOM messages and the communication of these messages.
PIDS 110 is mainly devoted to associating the received images with
the proper patient information, communicating with label imager 40
and medical imager 20 and providing a user with a visual interface
for operating and configuring interface device 30. More
specifically, PIDS 110 maintains information for each patient
scheduled to be examined and generates a unique identifier for each
patient. As will be detailed below, PIDS 110 ensures that unexposed
radiographic film is labeled with one of the unique identifiers
corresponding to the current patient being examined. Network
interface 100 is responsible for receiving the digital image data
from input imaging device 15 and analyzing the image data to
determine the unique identifier imaged on the digitized
radiographic film. Based on the determined unique identifier, PIDS
110 communicates the proper patient information to network
interface 100. In this manner, network interface 100 and PIDS 110
ensure the proper association of patient information to digitized
radiographic film. In one embodiment, network interface 100 and
PIDS 110 execute on a single computer. In another embodiment,
network interface 100 and PIDS 110 execute on two separate
computers such that network interface 100 executes on a computer
without a monitor or a keyboard and depends on PIDS 110 for visual
and administrative tasks.
FIG. 3 illustrates in detail one embodiment of network interface
100 having communication manager 120, OCR manager 150, DICOM
manager 130 and failure manager 140. In this embodiment,
communication manager 120 manages all communications of the network
interface 100 with the other components including input image
device 15, PIDS 110 and PACS 60. OCR manager 150 processes each
digital image received from input imaging device 15 according to
character recognition methods in order to determine patient
identification data recorded in the image data. In one embodiment,
OCR manager 150 extracts a patient ID code and other general
information of the patient which was imaged as a label on the
digitized X-ray film. DICOM manager 130 constructs any DICOM data
structures, such as messages or files, that are necessary for
communicating image and patient information to PACS 60. Failure
manager 140 handles any errors that may occur within interface
device 30 such as OCR failure or communication failure. OCR failure
is handled by storing the failed image and requesting operator
intervention by sending an OCR failure message to the PIDS through
the communication manager 120. Communication failure is managed by
storing the image and periodically retrying the communications. In
one embodiment, network interface 100 of interface device 30 is
directly connected to input imaging device 15 via a fast Ethernet
link, to PIDS 110 with a LAN link, and to PACS 60 with a LAN
link.
FIG. 4 is a flow chart illustrating one mode of operation of the
network interface 100. Network interface 100 begins execution in
step 200 and immediately proceeds to step 202 where communication
manager 120 waits for digital image data from input imaging device
15. When a new image is received, communication manager 120
proceeds from step 204 to step 206 and communicates the received
image to OCR manager 150. OCR manager 150 performs character
recognition operations on the image data in order to determine a
patient identifier, such as an ID code, stored in the image data
received from communication manager 120. If OCR manager 150 is
unable to retrieve a valid patient ID code, failure manager 140
stores the corresponding image in step 210 and sends an OCR failure
message to the operator through PIDS 110. In one embodiment,
failure manager 140 stores the failed image in a specific directory
of a hard disk embedded within network interface 100. After failure
manager 140 handles the OCR failure, network interface 110 returns
to step 202 and waits for subsequent images.
If OCR manager 150 is able to extract the patient identifier from
the received image data, OCR manager 150 communicates the extracted
patient identifier to communication manager 120. In step 214,
communication manager 120 communicates the patient identifier to
PIDS 110 and requests full patient information such as patient and
study data, general equipment data and secondary equipment data. In
one embodiment, communication manager 120 requests PIDS 110 to
format the information so as to comply with the DICOM standard. In
step 216, communication manager 120 determines whether the request
for patient information is successful. If the request does not
succeed, the image is stored by means of the failure manager 140 in
step 218 and communication manager 120 polls PIDS 110 until success
occurs in step 216 or a timeout expires in step 222. If time-out
occurs, failure manager 140 sends an error message to the operator
through PIDS 110. After failure manager 140 sends the error
message, network interface 110 returns to step 202 and waits for
subsequent images.
If the request for patient information succeeds in step 216,
network interface 100 proceeds to step 226 where communication
manager 120 communicates the patient information to DICOM manager
130. DICOM manager 130 receives the patient information and builds
a DICOM file by combining, according to the DICOM standard, the
image data and the data received from PIDS 110. DICOM manager 130
communicates the constructed DICOM file, or at least a pointer to
the DICOM file such as a filename, to communication manager
120.
In step 228, communication manager 120 transmits the DICOM file to
PACS 60. If a communication failure occurs while sending the DICIOM
file, failure manager stores the DICOM file in step 240 and
communication manager 120 waits for a success response from PACS
242 in step 242 until a second predetermined timeout expires in
step 222. If time-out occurs, failure manager 140 sends an error
message to the operator through PIDS 110. After failure manager 140
sends the error message, network interface 110 returns to step 202
and waits for subsequent images. If the constructed DICOM file is
successfully communicated, communication manager 120 sends an
acknowledgment message to PIDS 110. Network interface 100 proceeds
from step 248 to step 200 and waits for subsequent medical images
from input imaging device 15.
FIG. 5 illustrates one embodiment of PIDS 110 having information
table 300, visual interface 305, data server 310, print server 315
and Radiology Information System (RIS) interface 320. Information
table 300 contains information necessary to correctly associate
patient information received from RIS 50 with digital image data
received by network interface 100 from input imaging device 15.
Visual interface 305 provides a visual display and input interface
to the operator of interface device 30. Data server 310 manages
client/server communication and data transfer between network
interface 100 (the client) and PIDS 110 (the server). Print server
315 is the server component of a client/server interface to label
imager 40 (the client). RIS interface 320 is the client component
of a client/server interface between PIDS 110 and RIS 50 (the
server). Each of these components of PIDS 110 is discussed
below.
Information Table
PIDS 110 maintains information table 300 which defines all
information necessary to form a message, or file, for communicating
with PACS 60. In one embodiment, information table 300 includes a
set of databases and/or tables of the information needed to
construct a DICOM file according to the DICOM standard. In general,
the DICOM standard provides standardized format for images, a
common information model, application service definitions, and a
protocol for communication. Therefore, in this embodiment, the
information stored in the information table 300 includes: (1)
Patient's and Study Data, (2) General Equipment Data, and (3)
Secondary Equipment Data, and are preferably stored in three
different files (PSD file, GED file and SED file, respectively).
The information regarding patient's and study data is specific for
each patient. The PSD file is configured as a list of records where
each record corresponds to a patient. The following table lists the
various fields of a record in the PSD file:
TABLE 1 Data Structure Field (1 char = 1 byte) Patient Name Char
[64] Patient ID Char [64] Patient Birth Date Char [8] (Fixed
yyyymmdd) Patient's Sex Char [16] Other Patient ID Char [64] Study
ID Char [16] Study Date Char [8] (Fixed yyyymmdd) Study Time Char
[16] (Fixed hhmms.frac) Referring Physician Name Char [64] Study
Description Char [64] Admitting Diagnosis Description Char [64]
Accession Number Char [16] Series Number Char [12] Body Part
Examined Char [16] Laterality Char [16] Patient Orientation Char
[16] Unique (Axdis) Code Char [5] Fixed
Each of the above listed fields is divided in other two sub-fields.
The first sub-field contains the field identifier for the data
according to the DICOM standard. The second contains a
corresponding DICOM field value. For instance, the Patient Name
field contains the patient name and a predefined value, such as
00100010, which is defined by the DICOM standard.
The General Equipment Data describes the medical modality used for
primary capture and the institution and department name of the
organization that is performing the exam. This information is
usually common for each patient and is changed infrequently. The
following table describes one embodiment of the GED file:
TABLE 2 Field Data Structure Data Identifier Manufacturer Char [64]
0008,0070 Manufacturer's Model Name Char [64] 0008,1090 Institution
Name Char [64] 0008,0080 Institution Dept. Name Char [64]
0008,0050
The Secondary Equipment Data is common for every patient and is
rarely changed. The structure of the SED file consists in a unique
record which contains 7 fields as required by the DICOM standard.
It lists the values required from the DICOM standard for a
secondary capture device which, according to the present invention,
is a film digitizer within input imaging device 15. The following
table describes the fields of the SED file with the corresponding
data structure and DICOM data identifier:
TABLE 3 Record Data Structure Data Identifier Conversion Type Char
[16] 0008,0064 Modality Char [16] 0008,0060 SC Device ID Char [64]
0018,1010 SC Device Manufacturer Char [64] 0018,1016 SC Device
Manufacturer's Model Name Char [64] 0018,1018 SC Device Software
Version Char [64] 0018,1019 Digital Image Format Acquired Char [64]
0018,1023
Information table 300 further includes Process Information which
includes information relating imaging a label having the patient
identifier on a radiographic film. Preferably, this information is
stored in a file referred to as the ID ACK file. The Process
Information further includes information relating to the
notification that a DICOM file has been successfully sent to PACS.
Preferably, this information is stored in a file referred to as the
PACS ACK file.
Visual Interface
As mentioned above, visual interface 305 provides a visual display
to the operator of interface device 30 and allows the operator to
create, store and edit current patient information. Thus, visual
interface 305 main function consists in the creation and updating
of the PSD file containing all the patient and study data
associated with a patient identifier, such as an ID code. Visual
interface 305 receives a manually entered patient list from the
operator or, in another embodiment, retrieves a patient list from
RIS interface 320. More specifically, via visual interface 305, the
operator may easily build the list of patients who have been
scheduled for a particular day. The operator enters the patient
data, the day of the examination and other additional information.
Alternatively, the patient information is retrieved from the RIS 50
via RIS interface 320 by means of a client/server process. Visual
interface 305 generates the above described PSD file based on the
received patient list and stores the generated PSD file in
information table 300. In this manner, visual interface may be used
within a hospital environment where no RIS/HIS system is present or
in hospitals already equipped with a RIS/HIS.
In addition to facilitating the creation and maintenance of a
current patient list, visual interface 305 provides warning
messages in case of failure of various components/modules of the
system of the present invention. For example, visual interface 305
allows the operator to view the status of all the devices present
in the system. The operator may obtain a summary about the status
of all the device present in the system by accessing to a file
resident in network interface 100. Under request, visual interface
305 creates a status window and displays the status of each
devices.
Visual interface 305 also allows the operator to view images that
generated an OCR failure and to associate the failed images to the
proper patient information in the patient database. The operator
may view these images by using a particular command of visual
interface 305. When the image is shown, the operator can enter the
patient name and/or the ID code corresponding to the failed image.
The entered information is communicated from visual interface 305
to network interface 100.
Visual interface 305 also allows the operator to view an overview
status of each patient, such as, for example, label imaged (when
receiving the label imaged acknowledgment from the label imager,
print server 315 sets as done the Label Imaged field of the ID ACK
file), exams executed (when receiving the request of patient data
from network interface, the data server sets as done the Exam
Developed field of the PACS ACK file), exams sent to the PACS (when
receiving the acknowledgment flag from network interface, the data
server sets as done the Image Sent field of the PACS ACK file), and
so on.
FIG. 6 is a flow chart illustrating one mode of operation of visual
interface 305. Visual interface 305 begins execution at step 350 by
retrieving the current date. In steps 352 and 354, visual interface
305 determines whether a PSD file corresponding to the current date
exists within information table 300. If this file is not found,
visual interface 305 proceeds to step 356 and creates the PSD file
according to the current date. If the file is found, visual
interface 305 proceeds to step 358 and retrieves the data stored in
the PSD file. Visual interface 305 then proceeds to step 360 and
checks for the presence of RIS interface 320. If RIS interface 320
is detected, visual interface 305 proceeds to step 362 and sends
RIS interface 320 a request for a daily patient list. When visual
interface 305 receives the list, it updates the PSD file. Visual
interface 305 proceeds from steps 360 and 362 to step 364 and
generates a unique patient identifier, such as an ID code, for each
patient present in the PSD file. In one embodiment, visual
interface 305 generates a five digit ID code according to the
current date such that the ID code. The first two digits identify
the day of the current date and are comprised between 1 and 31. The
last three digits identify an entry within the PSD file and are
comprised between 0 and 999. Upon generating the patient
identifier, visual interface 305 proceeds to step 368 and loads the
GED and SED files and checks for the LAN connection with network
interface 100. If the LAN connection is not working, visual
interface 305 provides a warning message to the operator in step
370 and proceeds to step 380 and enters in a ready mode in which
visual interface 305 waits for messages from the operator or from
the other modules of the system.
FIG. 7 illustrates a plurality of operations that the operator can
perform via visual interface 305. When visual interface 305
receives an operator request, it proceeds through a series of
tests, indicated as steps 400, to determine the operation selected
by the operator. Upon determining the operation, visual interface
305 proceeds to the corresponding step and executes the selected
operation. Each operation is discussed below. 1. Insert new patient
data--step 402: the operator can add a patient, and the
corresponding data, to the daily patient list. Visual interface
creates an empty data window ready to accept new data. After
insertion of the new data, visual interface 305 updates the PSD
file and generates an ID code corresponding to the new patient. 2.
Confirm patient data--step 404: visual interface 305 confirms that
the data of a patient is correct. Visual interface 305 displays all
the patient data and checks the values according to the DICOM
standard. If a mistake occurs, a warning window appears to warn the
operator to correct the wrong value. After correction, visual
interface 305 updates the PSD file with the correct values. 3.
Search patient data--step 406: allows the operator to quickly check
if a patient is present in the PSD file. 4. List general
equipment--step 408: allows the operator to view and/or modify the
data contained in the GED file of information table 300. 5. List
secondary equipment--step 410: allows the operator to view and
change the data contained in the SED file of information table 300.
6. View system status--step 412: allows the operator to view the
current status of all the devices present in the system. 7. View
OCR failed images--step 414: allows the operator to view the images
not recognized by the OCR module in the network interface 100 and
to insert the ID code or the patient name corresponding to the
image shown. 8. Print label--step 416: allows the operator to print
a label containing a unique patient identifier and the main
generalities of the patient. This option is only available when the
system comprises the bar-code printer 70. This command allows to
print general patient information and a bar-code on a patient card
or sheet. 9. Cancel button--step 418: allows the operator to delete
the last operation performed. 10. Exit button--step 420: allows the
operator to exit from the program. Visual interface 305 saves all
introduced data into the corresponding files.
Data Server
Referring again to FIG. 5, data server 310 manages all
communication and data transfer between network interface 100 and
PIDS 110. Data server 310 receives the client requests from
communication manager 120 of network interface 100 for patient
information corresponding to a patient identifier. In response to
the request, data server 310 retrieves patient information from
information table 300 and communicates the information to
communication manager 120 of network interface 100. In addition,
data server 310 receives the failure messages coming from the
communication manager 120 and forwards them to visual interface 305
which displays a warning to the operator.
FIG. 8 is a flow chart illustrating one mode of operation of data
server 310. Data server 310 begins execution in step 450 and
immediately proceeds to step 452 and waits for incoming messages
from network interface 100. If there is a new message, data server
310 proceeds from step 454 to step 456 and determines the message
type. Based on the message type, data server 310 branches to steps
460, 462 and 468 when the message is of unknown type, an
acknowledgment or a request for patient information,
respectively.
When the message received from network interface 100 contains a
request of data, data server 310 reads the PSD file of information
table 300 to find the patient associated with the ID code received
from network interface 100. If the patient is found, data server
310 extracts from the PSD file all the patient data required for
the construction of the DICOM file, as well as the general
equipment data and the secondary equipment data which are stored in
the GED and SED files, respectively. After that, data server 310
builds a response message in step 474, sends the response message
to network interface 100 in step 476, and returns to step 452 for
receiving subsequent messages.
When the message received from network interface 100 is an
acknowledgment that a DICOM file has successfully been sent to PACS
60, data server 310 reads the PACS ACK file of information table
300 to find the patient associated with the ID code received from
network interface 100. If the patient is found, data server 310
writes the acknowledgment of image sent in the corresponding field
of the PACS ACK file in step 466 and returns to step 452 for
receiving subsequent messages.
When the message is not recognized by data server 310 in step 458,
or when data server 310 cannot find the patient in steps 470 and
464, data server 310 communicates an error message to the operator
through visual interface 305 and requests operator
intervention.
Print Server
The main function of print server 315 is to manage and server label
imager 40. More specifically, print server 315 access information
table 300 and facilitates the imaging of a label having a unique
identifier on unexposed radiographic film. In one embodiment, the
label is imaged directly on the radiographic film and is composed
of four rows, each of 32 characters. The first row contains the
hospital name, the second row contains the patient name and the
birth date, the third row contains the current date and the
hospital patient code, and the fourth row contains the current
time, the film orientation code and the unique patient
identifier.
Print server 315 is the server component of a client/server
interface to label imager 40. When label imager 40 is initialized,
it sends a message to print server 315 and requests the daily
patient list. In response, print server 315 retrieves a list of
unique identifiers for the patients from information table 300 and
communicates the list to label imager 40. In one embodiment, label
imager 40 includes a scroll display allowing the operator to view
the list, select a current patient and image a label containing the
corresponding patient information on the radiographic film. When
label imager 40 images a label, it sends a message to print server
315. Print server 315 receives the message that the label has been
imaged and sets a corresponding field in the ID ACK file.
In one embodiment, label imager 40 includes a bar code reader. In
this embodiment, label imager 40 reads a bar code from the patient
card, retrieves the patient information from the loaded daily
patient list and images the patient information on the radiographic
film. If, however, the read bar code information does not match any
patients stored in the current patient list, label imager 40 sends
a message to print server 315 containing the bar code information
together with a data request. Based on the bar code information,
which contains a unique patient identifier as printed by the bar
code printer 70, print server 315 retrieves patient information
from information table 300 or RIS interface 320 and communicates
the information to label imager 40 to be imaged on the radiographic
film label.
FIG. 9 is a flow chart illustrating one mode of operation of
printer server 315. Printer server 315 begins execution in step 500
and immediately proceeds to step 502 and waits for incoming
messages from label imager 40. If there is a new message, printer
server 315 proceeds from step 504 to step 506 and determines the
message type. Based on the message type, printer server 315
branches to steps 510, 512, 518 and 522 when the message is of
unknown type, an acknowledgment, a request for daily patient list,
or a request for patient information, respectively.
When the message received from label imager 40 contains the patient
bar code together with a request of data, printer server 315 reads
the PSD file of information table 300 to find the patient
associated with the bar code received from label imager 40 (step
522). If the patient is found, in step 526 printer server 315
extracts from the PSD file the main generalities and ID code of the
patient. After that, printer server 315 builds a response message
in step 528, sends the response message to label imager 40 in step
530, and returns to step 502 for receiving subsequent messages.
When the message received from label imager 40 is the request of
daily patient list, printer server 315 reads the PSD file of
information table 300 and extracts from the PSD file the main
generalities and ID code of all daily patients (step 518). After
that, printer server 315 sends the response list to label imager 40
in step 520, and returns to step 502 for receiving subsequent
messages.
When the message received from label imager 40 is an acknowledgment
that a label has successfully been imaged on radiographic film by
label imager 40, printer server 315 reads the ID ACK file of
information table 300 to find the patient associated with the ID
code received from label imager 40 (step 512). If the patient is
found, printer server 315 writes the acknowledgment of label imaged
in the corresponding field of the ID ACK file in step 516 and
returns to step 502 for receiving subsequent messages.
When the message is not recognized by printer server 315 in step
508, or when printer server 315 cannot find the patient in steps
524 and 514, printer server 315 communicates an error message to
the operator through visual interface 305 and requests operator
intervention.
RIS Interface
The purpose of RIS interface 320 is to manage the communication
with hospital's RIS 50 and to automatically create and update the
daily list of patients to examine. RIS interface 320 contains the
client component of a client/server interface, whose server runs on
RIS 50. RIS interface 320 contacts the RIS and requests the list of
the patients that are scheduled to be examined in a particular day.
RIS interface 320 also periodically checks RIS 50 for updating the
daily list. The updating procedure can also be activated by label
imager 40 and/or by the operator through visual interface 305 when
a patient is not found in the current list.
FIG. 10 is a flow chart illustrating one mode of operation of RIS
interface 320. RIS interface 320 begins execution in step 550 and
immediately proceeds to step 552 and waits for a message from
visual interface 305 requesting the daily patient list. When the
message is received, the RIS interface 320 contacts the RIS 50 in
step 556. If the RIS 50 responds, the RIS interface 320 asks the
daily list to the RIS 50 in step 564. If the RIS is not responding,
a loop is started in step 560 until to time out, after that an
error message signaling that the RIS 50 is not responding is sent
to the visual interface 320 for operator intervention in step 562.
Upon receiving the list from RIS 50, the RIS interface 320 reads
the PSD file of the information table 300 and verifies if the daily
patient list is already present. If so, the RIS interface 320
queues the additional patients in step 572; if not, the RIS
interface 320 creates the list and writes it to the PSD file in
step 568 and 570, respectively. After that, the RIS interface 320
returns to step 552 for receiving subsequent message.
Generating the DICOM File
As described in detail above, the present invention automatically
associates medical images generated by an input imaging device 15
with the proper patient information. In one embodiment, the images
and the associated patient information are associated and
communicated to PACS according to the DICOM protocol. The
information necessary to produce a DICOM file for communication can
be subdivided in five categories: patient's data, hospital data,
equipment data, image data and DICOM private data. Patient's data,
hospital data, and equipment data are stored in information table
300 of the PIDS 110, as described above. Medical image data is
produced by input imaging device 15 during digitization of the
radiographic film and are managed by network interface 100. Private
data is stored in the DICOM manager 130. The following tables
summarize the content of each category, distinguishing between
mandatory information (type 1), necessary information (type 2), and
optional information (type 3). Absence of mandatory information is
a protocol violation and produces an error, absence of necessary
information can be supplied with 0 value or no value, while absence
of optional information does not convey any significance and is not
a protocol violation.
TABLE 4 Patient related information PSD file Field Attribute Type
Patient Patient's name 2 Patient ID 2 Patient's Birth Date 2
Patient's Sex 2 Referenced Patient Sequence 3 Other Patient ID* 3*
Other Patient Names 3 Ethnic Group Patient Comments 3 Study
Referring Physician's Name 2 Study Description 3 Name of Physician
reading study 3 Patient Study Admitting Diagnosis Description 3
Patient's Age 3 Patient's Size 3 Patient's Weight 3 Occupation 3
Additional Patient's History 3 Series Laterality 2 Body Part
Examined 3 General Image Patient orientation 2 *The Other Patient
ID attribute contains the ID code generated by visual interface
305. Even if this attribute is optional for the DICOM standard, it
is necessary for the system of the present invention.
TABLE 5 General information GED file Field Attribute Type Series
Modality 1 Performing Physician's name 3 Operators' name 3 Protocol
Name 3 Series Description 3 General Equipment (optional)
Manufactures 2 Institution name 3 Institution Address 3 Station
Name 3 Institution Department Name 3 Manufacturer's Model Name 3
Device Serial Number 3 Software version 3 Spatial Resolution 3 Date
of last calibration 3 Time of last calibration 3 Pixel Padding
Value 3
TABLE 6 Reserved information SED file Field Attribute Type SC
Equipment Conversion Type 1 Modality 3 SC Device ID 3 SC Device
Manufacturer 3 SC Device Manufacturer's Model Name 3 SC Device
Software Version 3 Digital Image Format Acquired 3
TABLE 7 Image Information Field Attribute Type Image Pixel Samples
per Pixel 1 Photometric Interpretation 1 Rows 1 Column 1 Bits
allocated 1 Bits stored 1 High bit 1 Pixel Representation 1 Pixel
Data 1 Smallest Image Pixel Value 3 Largest image Pixel Value 3
Series Smallest Pixel Value in series 3 Largest Pixel value in
series 3
TABLE 8 DICOM private information Field Attribute Type Study Study
Instance 1 Study Date 2 Study Time 2 Study ID 2 Accession Number 2
Referenced Study Sequence 3 Series Series Instance UID 1 Series
Number 2 Series Date 3 Series Time 3 Referenced Study Component
Sequence 3 General Image Image Number 2 Image Date 2 Image Time 2
Image Type 3 Acquisition Number 3 Acquisition date 3 Acquisition
time 3 Referenced Image Sequence 3 Derivation Description 3 Images
in acquisition 3 Image comments 3 SC Image Date of secondary
capture 3 Time of Secondary capture 3 SOP Common SOP Class UID 1
SOP Instance UID 1 Specific Character Set 1 Instance Creation Date
3 Instance Creation Time 3 Instance Creator UID 3
Various embodiments of a method and system for associating exposed
radiographic film with proper patient information have been
described. The invention maintains information for each patient to
be examined in the current day and generates a unique identifier,
such as a unique code, for each patient to be examined. The present
invention images a label having one of the unique identifiers on
each unexposed radiographic film before the film is used in imaging
the patient via conventional x-ray techniques. After the film is
exposed, the film is developed and digitized. Patient information
is retrieved and associated with the digitized medical images by
analyzing the digital image data in order to determine the unique
identifier imaged on the radiographic film.
Several advantages of the present invention have been illustrated
including ensuring the proper association of patient information
with exposed radiographic film. Once properly associated, the
digital image data and the patient information can be communicated
to a Picture Archiving and Communication System. The present
invention also allows for interfacing with a hospital's Radiology
Information System, thus eliminating the need for manual entry of
patient information. This application is intended to cover any
adaptations or variations of the present invention. It is
manifestly intended that this invention be limited only by the
claims and equivalents thereof.
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